Once thought to be rare among children, pediatric ACL injuries have been diagnosed more frequently in recent years, a shift that could be attributed to aggressive athletic activity, the increasingly common practice of MRI scans for kids with hurt knees and physicians' heightened familiarity with pediatric ACL tears.
Treating pediatric ACL injuries can pose a challenge to surgeons, as ACL repair involves drilling into and potentially damaging the growth plate. The New York Times anecdotally cited cases of one child who underwent traditional ACL repair and wound up with one leg shorter than the other, as well as the story of an 11-year-old patient whose family sought out a surgeon who could repair the ACL while avoiding the growth plate. The specifics of the procedure weren't named, but the patient reported severe pain and a long recovery time following the operation.
Still, avoiding ACL repair makes the patient vulnerable to further injury, including secondary meniscal injuries, degenerative joint disease and joint instability. The University of Washington Medical School's guidelines for pediatric ACL tears suggests how the repair can be approached more safely, and one recent study (registration required) of 44 children found that Tegner and Lysholm scores improved to pre-injury levels after patients underwent the repair. Additionally, among this cohort there was no leg length discrepancy or angular deformity in any of the patients following surgery.
